Healthcare Provider Details

I. General information

NPI: 1225764624
Provider Name (Legal Business Name): ELIF BALIN LPC, NCC, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HIBBERT CT
PACIFICA CA
94044-1915
US

IV. Provider business mailing address

10 HIBBERT CT
PACIFICA CA
94044-1915
US

V. Phone/Fax

Practice location:
  • Phone: 814-206-4420
  • Fax:
Mailing address:
  • Phone: 814-206-4420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC007519
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: